1. Technical Field
The present disclosure relates generally to surgery. More particularly, the present disclosure relates to methods, devices, and systems for locating and treating uterine fibroids.
2. Discussion of Related Art
Fibroids are benign tumors of the uterine myometria (i.e., muscle) and are the most common tumor of the female pelvis. Fibroid tumors affect up to 30% of women of childbearing age and can cause significant symptoms such as discomfort, pelvic pain, mennorhagia, pressure, anemia, compression, infertility, and miscarriage. Fibroids may be located in the myometrium, adjacent to the endometrium (i.e., submucosal), or in the outer layer of the uterus (i.e., subserosal). Most commonly, fibroids are a smooth muscle overgrowth that arise within the walls of the myometrium and can grow to be several centimeters in diameter.
Current treatment for fibroids includes medical treatment with non-steroidal anti-inflammatory drugs (NSAIDS), estrogen-progesterone combinations, and gonadotropin-releasing hormone analogues (GnRH analogues). Pharmacologic therapy with GnRH analogues is limited due to its side effects, such as hot flashes, vaginal dryness, mood changes, and bone density loss. Further, its relatively short time of treatment (e.g., about 3 months) offers temporary shrinkage, wherein the fibroids may regrow after medical discontinuation.
Hysterectomy (i.e., surgical removal of the uterus) is a common treatment for fibroids. It is performed up to 600,000 times annually in the United States. Indeed, fibroids are the indication for hysterectomy in up to one third of all cases. Hysterectomy for treating fibroids is generally effective but has many undesirable side effects such as loss of fertility, open surgery, sexual dysfunction, and long recovery time. There is also significant morbidity (e.g., sepsis, hemorrhage, peritonitis, bowel, and bladder injury), mortality, and costs associated with hysterectomy treatments.
Surgical myomectomy may be an open or laparoscopic surgical procedure to spare the tissue of the uterus. As an open procedure, myomectomy requires a laparotomy and a large incision to provide a surgeon with access to the fibroids to be removed.
Laparoscopic myomectomy remains technically challenging. A surgeon must access the uterus through a small incision and dissect the fibroid from the uterine wall with limited access and with limited directions of traction. Moreover, once the fibroid is dissected from the uterine wall the fibroid must be morcellated to remove it through the incision.